Medicine is a Call to Political Action: Torture and Our Refugee Patients
As we progress in our clinical training, we accumulate stories. We carry the stories of patients who have changed us in unforgettable ways, stories shared with us by the ill or dying, and we too enter into the lives and stories of our patients. We bear witness to extraordinary pain and joy, yet I often feel helpless in the face of the fundamental causes of our patients’ health problems: inequality, structural violence, and political history. This, to me, is our profession’s call to advocacy, to stand for the health of our patients and communities.
Nearly 100,000 refugees have come to Minnesota alone in the last 30 years, bringing rich histories, culture, and values to the state. Many have also experienced torture and other forms of political violence, which are very much present in the clinic exam room. Whether or not we realize it, those experiences impact our medical care, from the patient’s symptoms to the dynamic of the conversation, to whether or not they take their prescribed metformin. Take, for example, one middle-aged patient resettled from a refugee camp, with a list of chronic conditions and an even longer list of medications. As we worked through his host of medical issues, I slowly edged closer to the fundamental issue: the tiredness in his eyes comes from chronic nightmares, the haunting of his memories, and the knowledge of family members left behind.
In recent weeks, we have heard the U.S. president talk about bringing back torture and saying that waterboarding – one of the most traumatic forms of torture – “absolutely” works. Countless survivors of torture have been forced from their homelands, separated from family and community, and often lived in refugee camps for years before coming to the U.S. Some were just beginning to heal from these assaults to both body and spirit when suddenly surrounded by news of a refugee ban, discrimination on basis of national origin, and even promotion of torture. An air of fear and uncertainty is understandably palpable.
It is an honor to share vulnerable moments with our refugee patients and to hear their stories of suffering, resilience, and hope. The weight of this work is overwhelming: daily, I see the effects of political violence played out on the bodies of patients. Sometimes, it can be evident through mental health effects, from depression and anxiety to psychosis. But even more often, it is the collection of symptoms that gives it away: chronic pain, fatigue, headaches, insomnia. For others, it is the occupational injuries: the exhaustion of worn-out bodies and souls, struggling to make ends meet as immigrant parents. As the next generation of physicians, we have a unique opportunity to understand this complex, yet fundamental, dynamic. The privilege of these stories also comes with a great responsibility: to do something about it. We are increasingly seeking to see illness in the full context of the patient’s life, rather than treating lab values or a purely chemical process. Similarly, we cannot sterilize medicine from its political content.
We are the future physicians of America. Join the call to protect refugees and to stand for the fundamental human rights and dignity of all of our patients.
What you can do:
Call your elected officials to oppose the executive order barring the U.S. Refugee Resettlement Program.
Learn more about Torture and take action: #RejectTorture
7 key point from the CIA torture report. Nytimes. Dec 4, 2014.
Nytimes: How U.S. Torture Left a Legacy of Damaged Minds. Oct.19, 2016 By Matt Apuzzo, Sheri Fink and James Risen
John McCain pledges to fight Donald Trump on torture. The Daily Beast. Jan. 25, 2017
Organize educational or advocacy events at your medical school: (Invite speakers, organize awareness weeks, screen a movie...etc. If you need help email us!)
Connect with your local refugee aid councils and volunteer to help support newly resettled refugee families.
Have questions? Email us at phr.sab@gmail.com